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The annual incidence of pneumococcal meningitis in 2016\u20132018 was 0.20\u20130.26 cases\/100,000 population<jats:italic>.<\/jats:italic> Age (p\u2009&lt;\u20090.001) and case fatality rate (p\u2009=\u20090.003) were significantly lower in patients with meningitis than in those without meningitis. The odds of developing meningitis were higher in asplenic\/hyposplenic or splenectomized patients (adjusted odds ratio [aOR] 2.29, 95% CI 1.27\u20134.14), for serotypes 10A (aOR 3.26, 95% CI 2.10\u20135.06) or 23A (aOR 3.91, 95% CI 2.47\u20136.19), but lower for those aged\u2009\u2265\u200965\u00a0years (aOR 0.59, 95% CI 0.44\u20130.81). PCV13 had an indirect effect on nonmeningitis, but its impact on meningitis was limited because of an increase in non-PCV13 serotypes. Of meningitis isolates, 78 (35.1%) and 3 (1.4%) were penicillin G- or ceftriaxone-resistant, respectively. We also confirmed an association of the <jats:italic>pbp1b<\/jats:italic>A641C mutation with meningitis (aOR 2.92, 95% CI 1.51\u20135.65).<\/jats:p>","DOI":"10.1038\/s41598-022-06950-w","type":"journal-article","created":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T06:03:09Z","timestamp":1645596189000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Pneumococcal meningitis in adults in 2014\u20132018 after introduction of pediatric 13-valent pneumococcal conjugate vaccine in 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